Reflections of a Dietetic Intern Through the Inaugural WVU ISPP Class

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Burlodge is a kitchen equipment company originating from Italy but has companies and factories in the United Kingdom, Italy, France, United States of America, and Canada. The headquarters in the US in based out of Winston-Salem, North Carolina.

What is the Multigen III 105 Series?

This piece of kitchen equipment is a revolutionary dual-oven technology that is used is a variety of patient foodservice systems around the world. The Multigen series allows foodservice professionals to re-thermalize products of different densities and textures to a consistent heat, insuring optimum food quality every time. Another beneficial characteristic of the Multigen series is the adaptability of the oven compartment which can be configured to various sizes to accommodate different meal arrangements. Basically, this piece of equipment is a multi-portion point of service trolley that is intended for cook-serve, cook-chill, and cook-freeze foodservice applications.

I was trained how to use this equipment yesterday at my patient foodservice rotation. The representative who trained the kitchen staff was a Registered Dietitian from Nashville, TN who worked for Burlodge.

The Burlodge equipment is broken down by different categories of major kitchen equipment:

–Tray Systems

–Bulk Systems

–Tray Assembly Systems

–Trayware

–Support Equipment

The Multigen III 105 Series falls in the Bulk Systems category and is a two compartment cart consisting of oven and refrigeration settings. The equipment is used in locations that cook, hold, and deliver food to other parts of the facility that are physically farther away than ideal. For example if a hospital setting had a nursing home attached, foodservice workers would be able to cart their Burlodge Multigen III over to the connecting facility, while the meals for service were cooking. Then, serve these meals without compromising the food safety of the meal.

With the beginning of summer, many people think they can just keep their picnic food safe from bacteria by storing it in the refrigerator. But, there is one bacteria- that is exempt from that rule…

Unlike most food bacteria, Listeria can grow in cool temperatures. Refrigerating food already contaminated with these bacteria could allow the germs to multiply and spread, according to the USDA.

The bacteria can cause serious illness known as listeriosis, which is especially dangerous for children, older people, pregnant women, and those with compromised immune systems. Foods in which Listeria has been found include deli meats, hot dogs, smoked seafood and store-prepared salads. The FDA advises those at greater risk for developing listeriosis to reheat these ready-to-eat foods until they are steaming hot. They should also avoid unpasteurized milk and soft cheeses.

Listeriosis has also been linked to contaminated cantaloupes. The FDA recommended washing all fruits and vegetables under running water immediately before eating, cutting or cooking them. Firm produce, in particular, should be scrubbed with a produce brush. Examples like this, is specifically important in the summer when fruits are in season.

Other ways to prevent Listeria infection include:

–Set your refrigerator temperature to 40 degrees F or lower to slow the growth of Listeria. Use a refrigerator and freezer thermometer to make sure temperatures are appropriately cold.

–Wrap or cover food before placing it in the refrigerator. Be sure no containers or covers are leaking juices on other foods.

–Do not allow cooked or ready-to-eat (RTE) foods to sit in the refrigerator. Eat these foods right away so Listeria doesn’t have the opportunity to grow. If you have leftovers in your refrigerator, it’s best to throw them out after 3 days, just to be sure. Because remember, it’s always better to be safe than sorry!

–Clean up refrigerator spills immediately. The FDA notes leaks or spills from hot dog packages, raw meat or poultry are mostly of concern. The agency advised cleaning these spills with paper towels to avoid spreading germs to a cloth towel.

–Routinely disinfect the refrigerator. Cleaning the inside walls and shelves of the refrigerator with warm water and soap. Surface cleaners can also be used monthly.

–Sanitize kitchen surfaces where food is prepared with soap and water and surface cleaner.

–Wash cutting boards after every use. Nonporous acrylic, plastic, or glass boards can be sanitized in the dishwasher.

–Wash dish cloths, towels and cloth grocery bags in the hot cycle of the washing machine.

–Before and after handling food, wash your hands with warm water and soap for at least 20 seconds! And if you can’t remember how long- just sing the “Happy Birthday” song. This is a trick we educate children on for food safety and hand washing!

According to the Center of Disease Control and Prevention (CDC), over 70 people in America have become sick because of a salmonella outbreak connected to imported Mexican cucumbers. The CDC reported that 14 people have been hospitalized and are trying to identify other people who could have been infected.

The source of the outbreak is thought to be Mexican supplier Daniel Cardenas Izabal and Miracle Greenhouse of Culiacan, Mexico. The cucumbers were distributed by Tricar Sales Inc. of Rio Rico, Ariz., the CDC said.

The Food and Drug Administration (FDA) has stopped the imports by Cardenas Izabal and Miracle Greenhouse unless they can prove that their cucumbers are not contaminated with salmonella. As of this point, California has reported the highest number of people who have fallen sick- 28. Among these people, the majority of them became sick between January 12th and April 6th. The outbreak reportedly reached its peak in early March but, the contaminated cucumbers have been pulled from shelves and are no longer on the market. But, the number of ill-stricken people could still rise. Due to the time it takes between when a person becomes ill and when the illness is reported, more sick people could come forward.

Most persons infected with Salmonella bacteria develop diarrhea, fever, and abdominal cramps 12 to 72 hours after infection. For example, the illness usually lasts 4 to 7 days, and most people recover without treatment. In some cases, the diarrhea may be so severe that the patient needs to be hospitalized-due to dehydration. Salmonella infection may spread from the intestines to the bloodstream and then to other body sites and can cause death unless the person is treated promptly with antibiotics. Children younger than 5 years, older adults, and persons with compromised immune systems are more likely than others to develop severe illnesses Salmonella.

Due to the recent government sequester that went into effect on March 1st, 2013, the Food and Drug Administration (FDA) will administer fewer number of food safety inspections throughout the country. While American consumers may not feel the impact immediately, the loss of $209 million from its budget will force the FDA to conduct about 2,100 less inspections. This reduction in food inspections account for an 18% decline compared to last year. The funding loss will also delay the agency’s implementation of the 2011 Food Safety Modernization Act.

Not only are food-borne illnesses (FBI) of concern but, the approval of new drugs are as well. All of the programs within the FDA are at risk for being compromised because of the huge cuts that are taking place. The Sequester is becoming a really big hit and I think that more and more people will start to experience that, and in turn realize its significance. The FDA does plan to prioritize programs that have the greatest effect on the public’s health, including disease outbreaks.

These next statistics are so ridiculous to me…. According to the Center for Disease Control and Prevention (CDC), 1 in 6 Americans, which equals 48 million people, develop a FBI each year. Out of these people, 3,000 people die and 128,000 are hospitalized. The FDA is already facing serious criticism, not to mention legal actions, for being slow to implement the food safety law. This law is geared towards refocusing the FDA’s efforts on prevention, instead of responding to crises. Since the law was signed into effect in 2011, it sat for 2 years with the White House Office of Management and Budget where it was rewritten in ways that weakened FDA’s oversight. The FDA claims that they’re frustrated with this situation, as is the rest of the country. The more time that goes by without this law going into effect, the more people that are at-risk of getting seriously sick.

But, I don’t believe that the FDA is as innocent as they might be leading on. Even before the Sequester, the FDA was able to inspect less than 2% of all food imports.

With an economical and attractive price, like arugula pizza or fish tacos, America’s 15,000+ food trucks are rolling into virtually every big city and a lot of small towns across the US.

The burning question: Is it safe to grab a bite to eat from a truck that cooks for hundreds in a space that’s a fraction of the size of your kitchen?

According to Health.com, yes, yes it is…

Just as the prices from their peers, though, some food trucks are better bets, food safety-wise, than others. Before you line up for your favorite lunchtime hoagie, here’s what you need to check for:

License

By law, food trucks need a license to operate so the local health department can track them for inspections. Why does this matter to you? Well, illegal operators tend to not worry as much about temperature and proper storage as an owner who knows an inspector could drop by at any time.

In many towns across the country, food-truck operators are required to post their license on the window, in a place where customers can see it.

Good grades

A number of cities require that food trucks place their latest inspection grade on the window that they serve food from. The worse the grade you see at your favorite food truck, the greater your chances are of getting a food-borne illness (FBI). If your city doesn’t post grades, they’re likely available on your local health department’s website.

Gloves

You might think your biggest worry is that the chicken or beef is undercooked, but you’re actually more likely to get sick because a food truck employee has bad hygiene. In fact, one of the leading causes of FBI is contamination from someone’s dirty hands.

Employees should be wearing gloves when handling your food, and changing them often, to avoid transferring bacteria from their hands to your food.

Gloves aren’t legally required everywhere, and an employee without them can handle food safely with utensils and regular hand-washing. This is a good sign that food safety is taken seriously at a restaurant/food truck.

Dangling hair

If employees don’t pull back their hair, they’ll be constantly moving it out of their eyes, then touching your food, which could get contaminated with bacteria from their face. Messy hair can also be a sign that a business isn’t following the food safety rules.

Lukewarm food

“Temperature problems are one of the most common violations in food trucks,” says Dr. Jonathan Fielding, director of public health for Los Angeles County. Salads and deli sandwiches should feel like they’re straight out of the fridge, while soup and burgers should be piping hot.

Messy sink

If you have a chance to peer inside the truck, try to find the sink. Look for soap, towels and a clear place for hand-washing. If the area is stacked up with dishes or there’s no soap in sight, where are employees going to wash their hands after coughing, sneezing or touching raw meat?

–One in 10 shoppers now choose higher-end cuts of meat in order to recreate a restaurant dining experience. In the past, consumers used to eat food for substance, today more people are having eating occasions that can be described as “savoring”, which conveys a new upscale eating experience defined by freshness, distinct flavors, and more.

2.Redefining Health

–Data shows that consumers relate the word “fresh” with “healthy”. Nine in 10 people think fresh foods are healthier, and 80% look for the descriptor “fresh” when it comes to retail and 58% in restaurants.

3.Generational Cooking

–Young adults are continuing to cut back on restaurant visits for the fifth year in a row, which means the market for the food industry to develop at-home meal products that appeal to the newest generation of cooks is on the rise.

4.Eating Alone

–There has been a dramatic increase in the number of adults who are eating solo, regardless of family dynamics. In addition to adults, children are also eating alone more often opening the market for new fresh/refrigerated meals for kids.

5.Seeking True Transparency

–Food safety is trending and doesn’t seem to be stopping anytime soon. 17 % of consumers have stopped buying a certain food or brand due to certain safety concerns.

6.Global Look-Alikes

–The integration of ethnic flavors, food items, and ingredients into American foods. Children’s sushi is predicted to be a hot trend for 2013.

7.Farmstead Formulations

–Hyper-local sourcing, like restaurant gardens, farm/estate brands, small-producer suppliers, and the mainstreaming of farmers’ markets all attest to consumers’ fascination and appreciation for all things agricultural related.

8.Craveable Finger Foods

–Restaurants have added bite-sized food to their menus and 67% of consumers find it “extremely appealing” to get their flavor through dips/condiments.

9.Nutritional Insiders

–In 2012 alone, 78% of consumers made a strong effort to get more vitamins and 57% tried to consume more products with specialty nutritional ingredients. The top vitamins were vitamin D, vitamin C, B-vitamins and omega-3s, antioxidants, vitamin E, and vitamin A.

10.Mother Hens

–Moms are more likely to buy nutritionally enhanced food and beverages. They are also more likely to seek out nutritional information. Moms want healthier kids’ food away from home.

March a big month in the realm of nutrition and dietetics. It’s not only National Nutrition Month but it’s also Frozen Food Month. Yes, frozen food DOES have its own month believe it or not…

Frozen produce is picked at its peak and flash frozen to maintain all the flavor and nutrients. The Frozen Food Foundation says that frozen fruits and vegetables are equally, and possibly more nutritious than fresh. When you buy fresh produce in the grocery store, it may have been harvested days before and may be past its peak by the time arrives. The produce may also not have been ripe when it was picked and may not be ready when it goes on sale.

Frozen foods keep longer, compared to fresh foods because the freezing process suspends enzyme activity that causes the food to spoil. Depending on the type of food, you can normally store food for several months without losing its quality. You can store it indefinitely if you use free-standing freezers kept at 0 degrees F. This alone can save you hundreds of dollars a year on groceries.

How can you freeze your foods safely?

– All foods can be safely frozen, but some foods should not be frozen for quality reasons (lettuce, tomatoes, cucumber, cream etc.)

– Most domestic freezers should operate at temperatures -18°C or lower. As a general rule, if your freezer can’t keep ice cream solid, its temperature is above the recommended level.

– Always refer to the on-pack ‘best before’ date. The manufacturer’s ‘best before’ date on frozen foods is a quality indicator and is the date until which the product will remain of peak quality (when stored at -18°C or below). For storage in a 3-star or 4-star freezer manufacturers will normally recommend ‘store until best before date’.

– After the ‘best before’ date a reduction in eating quality may become evident, whilst the product remains safe to eat.

– Try to rotate foods; putting newly purchased items at the back of the freezer so older items are used first.

– Most foods obey the rule ‘the colder the better’. Domestic freezers have a star rating indicating the temperature they are designed to operate at.

In honor of the month devoted to frozen food, I thought I would share how frozen food can be used as a healthy alternative!

Frozen Berry-Granola Squares

Ingredients:

– 1 c. whole grain granola

– 2 c. fresh strawberries, raspberries or combination

– 3 c. low-fat Greek yogurt

– 1/3 c. agave nectar

– 1 tsp. real vanilla extract

Directions:

– Line an 8-inch square baking pan with foil.

– Sprinkle granola evenly on bottom of pan and set aside.

– In a blender, whirl together berries, yogurt, agave nectar and vanilla until blended. Pour berry mixture over granola, smoothing mixture to the edges of the pan. Cover with foil and freeze until firm, approximately 4 hours. Keep frozen until serving.

Strawberry Frozen Yogurt

Ingredients:

– 1 lb. strawberries, rinsed and hulled

– 2/3 c. Splenda

– 1 cup skim milk yogurt

– 1 tsp. fresh lemon juice

Directions:

– Slice the strawberries into small pieces.

– Cover with plastic wrap and let stand at room temperature for 2 hours, stirring every so often.

– Transfer the strawberries and their juice to a blender or food processor.

– Add the yogurt and fresh lemon juice. Pulse the machine until the mixture is smooth. If you wish, press mixture through a mesh strainer to remove any seeds.

– Chill for 1 hour, and then freeze in your ice cream maker according to the manufacturer’s instructions.

On Wednesday January 30th, 2013, WELLWVU partnered with our Didactic Program in Dietetics at and we launched our first of four healthy food culture cooking classes on campus. This program planning started in the Fall 2012 semester. At that point, the program was initially a graduate student’s responsibility to plan, organize, and delegate but with hiccups in the way- WVU’s ISPP Dietetic Internship came to the rescue!

When we originally found out that Kaylyn Crosier and myself were going to be running the series of education programs that entailed nutrition and culinary skill-building, we though- why not incorporate food culture? Everyone loves learning about different food cultures but, this will make the series even more interesting, with the added culinary and nutrition components.

So, for our launch event- we decided on Mexico as our theme. In fact, A Mountaineer Mexican Fiesta. There was an estimated 25 students who were going to participate. WELLWVU purchased our groceries the day of the event. A created packet was given to each participant.

In each packet consisted:

Cover page: menu

Hand-washing visual guide

A PowerPoint presentation (printed) that Kaylyn created on knife skills

Mexican culture and diet handout

Nutritional benefits of tomatoes handout

Chile pepper handout

The set-up for the event entailed the aid from 2 undergraduate interns from our Human Nutrition & Foods department. We were responsible for setting chairs out for participants, hanging signage for each kitchen unit, setting out all kitchen utensils/tools at each unit, hanging decorations.

I created signs for students to pronounce menu items correctly, the program packets, the food guide pyramid signs, and delivered decorations for the Ag Sciences Annex Test Kitchen. I arrived at the kitchen at 3pm, the program lasted 6pm-8pm, and I eventually exited the kitchen at approximately 9:45pm.

Page 2 in participant’s packet

Front page article!

Students were educated on proper knife skills

Students learned the importance of washing all produce before using in the kitchen…

Chiles Rellenos!!

Chilaquiles… Mmmmm

Pico de Gallo!

Signs were placed near students on cutting board safety

One of the signs used in our presentation on nutrition. This was utilized/created to increase student’s culture awareness and pronunciation.

Another elderly person has died from accidental mushroom poisoning at a California senior care facility, bringing the death toll to four.

The latest victim, 92-year-old Dorothy Mary Hart, died at a nursing home, according to The Associated Press. The date of her death has yet to be released.

The first two women died the day after a caregiver at their senior-care facility inadvertently served them a meal with poisonous mushrooms picked on the Loomis, Calif., property Nov. 8. The caregiver and three other residents of Gold Age Villa were hospitalized, according to the ABC News affiliate in Sacramento.

Dr. Pierre Gholam, a liver specialist at University Hospitals in Cleveland, said he has seen an uptick in wild mushroom poisonings in his area, too. More than two dozen patients have arrived in the past three years with telltale mushroom poisoning symptoms, he said, including diarrhea followed by kidney and liver failure.

Gholam, speaking to ABC News by phone from a meeting of the American Association for the Study of Liver Diseases in Boston earlier this month, said doctors there from across the country report similar increases in mushroom poisoning patients, even in areas not typically known for mushroom poisonings, such as the Midwest.

“Clearly, there is something that has changed, in my mind, that has led to more mushroom poisoning cases,” he said. “It looks like a nationwide phenomenon.”

The reasons are unclear but Gholam suggested that more people could be picking their own mushrooms in the bad economy to save money.

Gholam’s hospital is one of only a few authorized by the federal government to give patients an antidote called silibinin, which blocks the poison from attacking the liver. Fourteen patients have come from up to 150 miles away for the life-saving drug.

The poison in these mushrooms is called amatoxin, and it’s colorless and odorless, so people who pick or eat them won’t know until it’s too late, Gholam said. The poison fungi can also come in different sizes and shapes. Cooking or freezing the mushrooms does not deactivate the toxin.

Typically, people begin to feel sick within six hours of eating the mushrooms, and come down with severe diarrhea, which causes dehydration and kidney failure, he said. Without the antidote, liver failure can set in after 72 hours, and the needs a liver transplant after 96 hours.

Menu labeling laws are creating new jobs for RDs in nutrition analysis, menu development, and more. Despite challenging economic times, people are eating out more than ever.

Obviously, today’s eating-out scene isn’t what it used to be. It’s no longer an occasional treat. In fact, it’s become mainstream. Part of the reason is that reason is that restaurants are reaching more people in more powerful ways. Social media, big-batch couponing, and targeted marketing and advertising are wildly popular, and restaurants often promote nutrition and health-related messages.

Food is a competitive business, and restaurants stand out offering what people want. Weight-conscious consumers demand tasty, low-fat, low-carb, and low-calorie. Eco-conscious customers seek restaurants that promote social responsibility and sustainability and offer local selections. Health-conscious clientele ask for nutrition and allergy info as well as options for special diets such as low sodium, vegan, gluten-free, and oil free. In fact, according to a National Restaurant Association (NRA) survey of 1,800 chefs, health/nutrition, gluten-free/allergy-free fare, children’s nutrition, and healthful kids’ meals are among the 20 hottest restaurant trends of 2012.

The sky’s the limit for RDs in restaurants nowadays. Some of the most important roles RDs can play in the restaurant industry include providing nutrition information, developing menus for special needs customers, helping with food safety and label regulation compliance, and marketing.

Nutrition analysis is one of the many menu-consulting services RDs can provide to restaurants. Others include recipe creation, menu development, recipe makeovers for improved nutrient profiles, identification and development of selections that meet guidelines for specific diets and dietary restrictions, adaptation of recipes for health conditions, and assistance with increasing perceived healthfulness of menus.

RDs with strong culinary backgrounds are ideal for assisting restaurants with developing new flavor profiles and ingredient combinations while meeting calorie and nutrient targets, sourcing fresh/local or unusual ingredients, and even helping with food budgeting. RDs also can train staff on topics that bring together nutrition and culinary arts in unique and interesting ways.

Developing, defining criteria for, and implementing special dietary meal, such as heart-healthy choices, are other opportunities requiring RDs expertise. In some cases, programs with nutrition criteria already exist, and the restaurant simply needs help identifying and developing menu items that meet the criteria. One example is the NRAs Kids LiveWell program, which already has established criteria for its participating menu items.

Another critical area of opportunity for RDs in the restaurant industry is food safety. Becoming ServSafe certified is one way to get your foot in the door. RDs also can become involved with state-specific compliance measures with the department of health, front- and back-of-the-house food safety training programs, food allergen labeling, and food allergy protocol training, which entails the prevention of allergen cross-contamination.

Food Safety at its finest!

RDs with experience in public relations and marketing are valuable additions to restaurant teams. For example, experts in customer relationship management give restaurants an edge with the use of social networking tools and social influence marketing. Being the healthy voice of a restaurant can be accomplished through marketing materials, becoming a spokesperson, interviews, food demos, tastings, seminars, workshops, health fairs, lectures, and trade shows.

RDs are in high demand to help restaurants comply with menu labeling laws. In addition to providing soon-to-be-required nutrition information, like calorie counts on menus, menu boards, food display tags, and at drive-thrus, restaurants will need assistance understanding health claims, FDA legislation, requirements, exemptions, and recommendations. Chain food establishments, including grocery store cafés and convenience stores, as well as those managing vending machines soon need to comply with the laws too. These businesses may know less about menu labeling than traditional restaurants and will be receptive to RDs expertise.

Despite mixed study findings on the effectiveness of menu labeling on food choices and behavior and its influence on the obesity epidemic, no one can ignore the fact that people want nutrition information. They also want healthful, tasty, balanced meals. Smart restaurants appreciate the value that dietitians bring to the table and understand the importance of customer loyalty. For nutrition professionals to effectively sell their services to restaurants, they need to be armed with persuasive evidence that illustrates their value.

RDs make the perfect partners for restaurants that care about the accuracy and quality of nutrition information they provide. A restaurant needs to protect its credibility. Restaurant nutrition consulting involves a high level of skill, knowledge, education, experience, and responsibility, and RDs are the best fit to ensure that nutrition information is accurate and doesn’t mislead consumers. And if food labels or nutrient claims are involved, RDs are familiar with FDA regulations.

RDs understand the bottom line.

RDs know that a restaurant is a business, and businesses must turn a profit. They know that being sensitive to the financial challenges of restaurateurs is an important part of forging a successful working relationship. When setting fees, a little creativity and flexibility regarding bulk pricing, package deals, and other compromises may, depending on the situation, result in a win-win.

RDs are also aware that chefs are passionate about the tools they create and may be resistant to standardizing recipes and following guidelines that ensure consistency and accuracy in recipe analysis. It’s important to respect the need for creativity and agree on ways to retain the food’s high quality while providing accurate, reliable information.

As for nutrition professionals, there is no better time to explore career opportunities in the restaurant industry. Restaurateurs need our expertise on many levels to provide healthful foods and accurate nutrition information in creative, innovative ways during a time when obesity and chronic disease is at an all-time high. Without a doubt, our generation has to make a difference….